Independent Nurse Prescribers’ Contributions to End-of-Life Prescribing

Why is the research needed?

Independent nurse prescribers are increasingly central to community end-of-life care, where timely access to symptom management medications is critical to preventing distress for people dying at home. Registered nurses holding an Independent Prescriber qualification, such as the V300 or V200, are able to prescribe these medications within their scope of practice, yet how often they do so, and what shapes this practice, is not well understood.

Existing evidence consistently calls for more independent nurse prescribers to address access to end-of-life medication issues but does not examine the structural and cultural factors that enable or constrain nurse prescribing practices. Understanding this is important for planning the training, guidance and system-wide support that enable independent nurse prescribers to use their qualifications and facilitate timely end-of-life symptom management.

What are we doing? 

We are investigating how frequently independent nurse prescribers prescribe end-of-life symptom management medications and exploring the perceived facilitators and barriers that influence this practice.

Data will be collected through a brief, anonymised online survey in 2026. Eligible participants are UK-based registered nurses who hold a V200 or V300 Independent Prescriber qualification and are currently practising in community settings. Participants will be asked to self-report their end-of-life prescribing practices, access to support, and recent experiences of prescribing end-of-life symptom management medications.

Responses to multiple-choice questions will be analysed statistically to describe prescribing frequency and examine variation across organisational and other relevant factors. Free-text responses will be analysed qualitatively to explore facilitators and barriers to prescribing and to identify opportunities for strengthening system-wide support structures.

How are we working with communities, services and organisations?

We are working with a team of community nurses from a range of UK-wide NHS Trusts to design the survey questionnaire and will continue to collaborate with them to facilitate recruitment of independent nurse prescribers and implement our knowledge mobilisation and impact plans.

What will the impact and benefits of this research be?

This study will generate evidence on the frequency and variation of end-of-life prescribing by independent nurse prescribers, as well as the facilitators and barriers that shape this practice. The findings will be disseminated to a broad academic, clinical, and policy audience to inform system-wide improvements and strengthen support for independent nurse prescribers.

What do we have planned for knowledge mobilisation and implementation?

We plan to publish our findings, present them at relevant primary care conferences, and engage with service commissioners to support workforce planning and inform service development.